Bruce R Penn Inc

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW002606 Issued in GA

Legal business name

BRUCE R PENN INC

Practice address

5165 Lavista Rd
Tucker, GA 30084-3602

Phone

(770) 908-1746

NPI assigned

Jan 19, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Nancy F Penn, LCSWNPI 1053479113

Title

Authorized Official

Phone

(770) 908-1746

Specialties & licenses 1

Addresses

Other names 1

• Healing Transitions Counseling Center Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nancy Foster Penn, LCSW

  • Clinical Social Worker
  • Tucker, GA
  • NPI 1053479113
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1232323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232323200000",
    "number": "1023255684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4378 SLEEPY HOLLOW CV",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300474196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5165 LAVISTA RD",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300843602",
            "telephone_number": "770-908-1746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE R PENN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-19",
        "last_updated": "2009-01-19",
        "status": "A",
        "authorized_official_last_name": "PENN",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "770-908-1746",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW002606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healing Transitions Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Diana Brown
• John Irvin Brown IV, DC
• Keisha Brown, M.D.
• Monjah Browne, MS, BCBA
• Browns Medical Center LLC
• Keith R Bruno, MD
• Nicole Fernandez Brunton
• Erica M Bryant, PHARM.D.
• John William Budell, MD
• Building Roses Health & Wellness

• Clinical Social Worker in Tucker, GA
• Providers in Tucker, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.